December 7, 2024

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Q&A about medical school at LDS Church-sponsored Brigham Young University

Q&A about medical school at LDS Church-sponsored Brigham Young University

There are still a lot of unknowns about Brigham Young University’s upcoming medical school.

The private religious college, sponsored by The Church of Jesus Christ of Latter-day Saints, announced its plans Monday without a lot of details. But here is a breakdown of some initial questions and answers — like how the new doctor of medicine program will work with the school’s Honor Code and Utah’s health care providers, and why it won’t have an associated hospital on the Provo campus.

How many medical schools are there in Utah?

There are currently three medical schools in the state. The largest is the Spencer Fox Eccles School of Medicine at the University of Utah, which is a public program with a connected hospital.

The other two are private: Noorda College of Osteopathic Medicine in Provo and a branch of Rocky Vista University College of Osteopathic Medicine near St. George.

Another private school, Roseman University, has a campus in South Jordan focused on health sciences, including dentistry and nursing. Currently, the school’s campus in Nevada is trying to get accreditation for a medical doctor program there. Spokesperson Jason Roth said one could come to Utah in the future, but it wouldn’t be any time soon.

When will BYU’s medical school open? And how many students will it accept?

In their statement, the LDS Church’s top leaders did not provide any specific details as far as dates or numbers of students who will be admitted into the future program. The First Presidency indicated only that, with time, it anticipates drawing students “from within and outside the United States.”

BYU’s spokesperson declined to answer questions, referring instead to a brief statement from the school’s President C. Shane Reese: “A planning team is being established to work on this initiative and more information will be shared as plans develop.”

It is worth noting, though, that BYU currently ranks No. 23 in the country for the number of graduates it has that apply to continue their education at a medical school.

The Association of American Medical Colleges reports that 387 students with a BYU undergraduate degree applied to a medical school in the 2023-24 academic year. That also put the institution at No. 2 out of three for schools that don’t have an affiliated medical school.

Within Utah, BYU outpaces the U. in this statistic — showcasing a desire among students there to get into the medical field. The University of Utah had 209 undergraduate students apply. Utah State University had 69 students apply. No other Utah college made the list, which tracks schools with more than 50 applicants.

How many students apply to the University of Utah’s medical school?

There is high interest, though, in students across the country specifically wanting to attend the U.’s top-ranked medical doctor program. For this fall’s incoming class, the U. had 2,500 applicants. Of those, 2,082 met the minimum requirements (with GPA and entrance exam scores).

Ultimately, 360 were interviewed. And admission was offered to 170, said Kathy Wilets, the spokesperson for University of Utah Health (not all will attend, as some students get admitted to multiple schools). That’s an acceptance rate of 6.8%, which is fairly standard for medical schools.

The number of U. students who can enroll in medical classes each year is capped, though, by the Utah Legislature.

The school relies on taxpayer funding, and it can annually afford to have 122 students in an entering class, under funding legislation first passed in 2013. That legislation allocated $10 million in ongoing funding to the medical school. Idaho funds two additional positions, and there is one slot for a MD-PhD-combined position. That brings the total to 125, and the admission rate to 5%.

With four years of training, that means there are 500 medical students total at a time. There are roughly 800 residents working with University of Utah Health, too.

Wilets, though, said the U. wants to increase that number in coming years. The school has previously said it would like the number of students in an entering class to be at 155.

She said the U. intends to work with lawmakers to accomplish that — and on an expansion into southern Utah. The U. plans to present plans for a regional medical campus in St. George to the Legislature this coming spring, its statement said.

That expansion would likely require additional state funding. (Though the U. has also used private funds, including some for the construction of its new medical school building opening in 2026.)

While the number applying to the U.’s medical school has remained steadily increasing, the number of medical graduates seeking to do their residencies in the state has declined, with a 13.1% drop last year.

The Association of American Medical Colleges’ think tank points to Utah’s restrictive policies on abortion as the cause, as with other similarly positioned declining states.

What do the University of Utah and Intermountain Healthcare have to say?

(Ed Kosmicki | Special to the Tribune) Spencer Fox Eccles (center right) reacts at the announcement of the renaming of the University of Utah School of Medicine to honor him on Wednesday, June 9, 2021.

U. leaders welcomed the addition of BYU’s medical school. And both colleges signaled their intent to collaborate, particularly with clinical care.

BYU says it intends to focus on international health, while the U. continues to address local, statewide health, approaches they described as complementary.

“The U. and BYU can strive to meet existing and future health care professional shortages, provide more opportunities for aspiring medical providers and contribute to the health care needs of patients in our region and around the globe,” said U. President Taylor Randall in a statement.

BYU said it will also partner with Intermountain Health, a not-for-profit health care system headquartered in Salt Lake City that offers care across Utah, Nevada, Colorado, Idaho, Montana, Wyoming and Kansas.

Intermountain’s spokesperson Glen Beeby said the organization would not be commenting Monday outside of this prepared statement: “Intermountain Health will engage with BYU in exploring and defining what a future relationship might be. Intermountain Health also anticipates continuing its clinical relationship with the University of Utah.”

How bad is the doctor shortage in the state? And will BYU’s medical school help?

Numbers across the state — and country — show a deficit in the number of physicians needed for the growing population. The ratio of active doctors to Utah residents has been lower than the ratio for the United States since at least 2008.

As of 2019, the most recent data available, there were 21 physicians for every 10,000 people in Utah. Across the country there are 29.9 doctors per 10,000 people, according to comparative data from the Utah Department of Health and Human Services.

Sam Finlayson, interim dean of the U.’s Spencer Fox Eccles School of Medicine, said the number applying to the U.’s medical school that cannot be admitted because of the cap “highlight the high demand for medical education in our region.”

The U. has offered academic health science programs since 1905. It currently operates five hospitals and 12 community health centers.

But even with that, the federal Health Resources and Services Administration indicates that Utah has 179 “health care provider shortage areas.” Residents have reported waiting months for appointments at all clinics.

Utah Gov. Spencer Cox similarly championed BYU’s future medical school as a way to address that problem, though it’s not clear how much of an impact it will have — particularly as the church has said the focus is on international health.

“This is great news not only for BYU but for all Utahns as we seek to increase educational opportunities for those looking to enter the medical profession and increase access to health care worldwide,” Cox said on social media.

The U. uses taxpayer funds for its medical school. Will BYU seek the same?

It’s not clear yet if BYU will ask for taxpayer funding; the school declined to answer that question Monday.

With its sponsorship from The Church of Jesus Christ of Latter-day Saints, the school will be able to tap into the faith’s resources. The global church’s investment arm, Ensign Peak Advisors, had stock holdings worth $54.7 billion as of late March in its publicly reported portfolio.

Will BYU now have a hospital?

No, the private school will notably not have an associated hospital with its medical school.

The LDS Church was previously involved in running hospitals, but sold those in 1975 to what is now Intermountain Health. BYU will partner with Intermountain Health, particularly to give its students the required amount of clinical experience, according to the Monday announcement.

It is an unusual setup not to have a connected hospital, but it’s not unheard of. A 2018 story from Inside Higher Ed pointed to the financial difficulties and liabilities for a school to run a hospital.

It noted Georgetown University, Harvard Medical School, Vanderbilt University and University of Maryland all dropping ownership of hospitals but keeping their medical programs for students.

Georgetown University, also a private, religious school, is a good comparison for what BYU’s program may look like. Georgetown partners with several medical centers and, among others, the MedStar Georgetown University Hospital. The university is a Jesuit institution.

What will BYU’s medical school focus on?

In the announcement about the medical program, the faith’s leaders said instruction will focus on “international health issues affecting members of The Church of Jesus Christ of Latter-day Saints and the Church’s worldwide humanitarian efforts.”

They continued: “It is envisioned that unlike many medical schools, the BYU medical school will be focused on teaching with research in areas of strategic importance to the church.”

The faith does proselytizing worldwide and has global membership.

Daniel Sulmasy, the director of the Kennedy Institute of Ethics and a professor of medicine and philosophy at Georgetown University, called that mission “terrific.”

“I haven’t specifically seen that,” he said. “But there are good religious reasons for Catholics, Mormons, Muslims, as being part of worldwide religions, to want to be able to give the best medical care to people in other countries.”

Churches, he said, already have the network in those places through their missionary work. And the best way to reduce cases of malaria, trachoma and HIV in those places, he said, is with religious institutions that care about the communities and invest in them.

As a private, religious school, can BYU choose what topics it teaches to medical students? Will classes cover abortion, for instance? Or LGBTQ+ health?

Most medical schools, including those tied to religions, feel they must teach students about all aspects of medicine, Sulmasy said. And that includes complicated topics, like abortion, which the LDS Church, for instance, opposes “for personal or social convenience,” according to its guidelines for members.

Sulmasy said he expects BYU’s medical school will address abortion, as does his Catholic institution, Georgetown University. There, students are instructed on the topic in the classroom, but there is no physical instruction on it; the procedures are not performed or observed by students in any capacity.

“We teach people what an abortion is because people need to know that,” he said. “They need to know what the consequences could be if someone has a complication.”

The line, he said, is that it is taught but not endorsed. “I think that’s the same kind of thing that would happen at a place like BYU,” Sulmasy said.

Similarly, Benedictine College, a private Catholic institution in Kansas, which anticipates opening a medical school in fall 2027, will strictly follow the outlines of the faith, which opposes all abortions and contraception. It will teach students about abortions from a scientific perspective, according to an article in Inside Higher Ed, but it will advise students on the Catholic view on the topic. Students will be instructed to counsel patients on carrying out a pregnancy to term and considering alternatives to abortion, such as adoption.

“They’ll understand what abortion is, how they’re done, what medical issues are around abortion and complications,” George Mychaskiw, the founding president and CEO of the future school, said to Inside Higher Ed. “But the school will also have the firm moral, Catholic position on the acceptability of abortion and any instances where it’s involved.”

At the same time, Sulmasy said, there is no technical requirement that a medical student must be able to perform an abortion, for instance, in order to be a physician.

And the body that accredits all academic medical doctor programs in the United States — the Liaison Committee on Medical Education — does not specifically require that instruction in its standards for curricula.

Veronica Catanese, co-secretary and senior director of accreditation services for the committee said in a statement: “All medical education programs accredited by the LCME must meet the same requirements put forward in the standards and elements. … It expects that the curriculum of its accredited programs is of sufficient breadth and depth to prepare medical students for entry into any residency program and for the contemporary practice of medicine.”

The broad requirements from the committee direct schools to “ensure that the medical curriculum includes content and clinical experiences related to each organ system; each phase of the human life cycle; continuity of care; and preventive, acute, chronic, rehabilitative, and end-of-life care.”

Faculty are ultimately responsible for setting the standards and choosing the content.

The 35-page standards acknowledge “the existence and appropriateness of diverse institutional missions and educational objectives,” but it also says that does not “justify accreditation of a substandard program of medical education leading to the MD degree.”

What about instruction on LGBTQ+-specific health care and disparities?

The accreditation requirements say students should be taught to be accepting of diversity within the field. It makes no mention of the queer community.

BYU, though, previously came under fire in 2022 for canceling gender-affirming care for LGBTQ+ patients at its speech clinic. The school announced that those voice therapy services, used to help transgender clients match the tone and pitch of their voice to their gender identity, did not align with the faith’s policies.

Without a university-owned hospital, BYU medical students won’t be working with patients on campus for their clinical experiences. So it is unclear if a similar situation would or could play out.

But it doesn’t appear likely to affect an accreditation decision either way.

(Leah Hogsten | The Salt Lake Tribune) A Brigham Young University student wears a rainbow heart pin she made last week in protest of the school’s Honor Code policy regarding same-sex romantic behavior in 2020.

How will BYU get accreditation for the medical program? How long does it take?

It’s likely BYU will go through the Liaison Committee on Medical Education for accreditation (only osteopathic programs use a different accreditor).

The University of Utah is accredited through the committee, for instance, which serves both public and private institutions and is recognized by the U.S. Department of Education.

An online copy of the committee’s standards notes that it has 12 requirements that medical schools must meet, such as having a mission statement and a sufficient number of faculty. It also requires students require 130 weeks of instruction.

Receiving accreditation is a lengthy process that can take several years, but while it is voluntary, most schools seek it. Programs start in applicant status and must submit required data within 18 months of that. Then, the committee will formally review the school for approval or denial for candidate status. If a school is denied, it must wait 12 months to reapply.

If the school gets candidate status, there is a survey visit before preliminary recognition. With that, a school can begin enrolling students into the recognized program. There are then requirements for provisional status before full accreditation.

And there are annual requirements to maintain that.

Benedictine College, for instance, announced its plans to open a medical school in 2022. It finished an accreditation application for an osteopathic program in 2024. It doesn’t expect to open until 2027.

That means BYU’s medical school could still be a long way from opening.

Can BYU ask medical students to abide by its Honor Code?

Yes, according to the standards from the Liaison Committee on Medical Education. The committee says that a school’s faculty can establish its own criteria for student admission and discipline.

And other private, religious medical school programs already do so.

Loma Linda University in California, which has its own medical school, operates under the Seventh Day Adventist faith. It is accredited by the committee and requires students sign a lifestyle agreement that they will uphold when they are enrolled.

That agreement is similar to BYU’s Honor Code; at BYU, students are required to abstain from sex before marriage, as well as being prohibited from consuming coffee, alcohol and tobacco.

At Loma Linda, students — explicitly including those in the medical program — also must refrain from using “tobacco, alcohol and other recreational or unlawful drugs during the period of their enrollment at the university,” according to a copy of the 310-page student handbook posted online. They may not view pornography. And they are also required to be chaste before marriage.

“We believe that God’s ideal for sexuality is achieved when premarital and extramarital sexual expression and conduct are chaste, and behaviors that suggest otherwise are avoided,” it states.

They also may not have visible tattoos or body piercings (except on ears). And they are required to attend chapel services.

“All violations of these policies shall be subject to disciplinary action, up to and including immediate termination of employment or student expulsion,” the policy adds.

The school declined to comment to The Tribune.

Can BYU discriminate on who it accepts to its medical school?

BYU cannot choose only to accept members of the faith, for instance, or discriminate with applicants based on personal identity in any other way, if it wants to be accredited.

That’s one of the specific requirements from the Liaison Committee on Medical Education. While BYU can require students to abide by its rules, it cannot selectively admit applicants and must try to have a diverse student body, according to the committee.

That’s how BYU currently operates with its undergraduate and existing graduate programs.

What other private, religious medical schools are in the country?

Sulmasy counts four Jesuit-run medical schools in the United States: Georgetown University (Washington, D.C.), Creighton University (Nebraska), Loyola University (Illinois) and St. Louis University (Missouri).

New York Medical College, he noted, was purchased by the Jewish faith, as well as Touro University California. And Loma Linda University by the Adventists.

“They help the diversity of medicine,” he said. “People of different faiths can see ways of bringing the resources of their own religious beliefs to the practice of medicine.”

There also is future Benedictine College medical school. And the school of medicine at Texas Christian University was awarded accreditation late last year.

Sulmasy said, though some may be wary, there is an obvious connection for him between medicine and religion. “There are still large numbers of physicians that think of medicine as a calling,” he said.

And the word “hospital” comes from the monastic value of hospitality, he said, where people would visit a monk for herbal treatment.

“The connection between religious work and charity and medicine has been strong for quite a few millennia,” he said, “and most of western medicine grew out of that tradition.”

He believes BYU’s medical school will not be any different.


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